VEGF 在三阴性乳腺癌中的表达及临床意义

VEGF Expression in Triple-Negative Breast Cancer and Its Clinical Significance

目的:探讨VEGF在三阴性乳腺癌中的表达及临床意义。方法:选取天津医科大学附属肿瘤医院2007年11月至2008年6月间560例乳腺癌,用免疫组织化学方法检测肿瘤组织VEGF的表达状态,分析其与各临床病理特征的关系,以及在三阴性乳腺癌中的表达和预后作用。结果:乳腺癌患者中VEGF的阳性表达率为36.1%(202/560),其中三阴性乳腺癌中阳性表达率为45.0%(49/109),明显高于非三阴组33.9%(P=0.031)。VEGF的表达与患者年龄、肿瘤部位、病理类型、肿瘤大小、淋巴结状态、病理分期、组织学分级和p53状态均无明显相关(P>0.05),但在低年龄组(66.7%vs.41.7%)、淋巴结转移组(51.1%vs.37.1%)和p53阳性组(51.8%vs.34.0%)方面发现VEGF表达有增多的趋势。三阴性乳腺癌VEGF阳性者较阴性者易发生复发和转移(23.9%vs.9.7%),3年无疾病复发率明显低于VEGF阴性组(76.6%vs.90.3%,P=0.044)。结论:VEGF可以作为三阴性乳腺癌影响复发的预后因素之一,有可能成为三阴性乳腺癌靶向治疗的研究靶点。

Objective： The current study aims to investigate the expression of the vascular endothelial growth factor （ VEGF ） in triple-negative breast cancer （ TNBC ） and its relationship with the prognosis. Methods： The medical records of 560 breast cancer patients who underwent surgery in Tianjin Medical University Cancer Institute and Hospital between November 2007 and June 2008 were reviewed. Immunohistochemistry was used to determine the VEGF expression in TNBC patients and to analyze the relationship be- tween VEGF expression with clinicopathologic characteristics and the prognostic value. Results： The VEGF positive rate was 36.1% in all of the breast cancer cases （ 202 / 560 ）. Moreover, the VEGF expression was significantly higher in TNBC cases than in non-TN- BC cases （ 45 % versus 33.9 %, P = 0.031 ）. No significant correlation was observed between the different VEGF expression levels and patients＇ age, tumor location, histology, tumor size, lymph node, pathological stage, histology grade, or p53 （ P 〉 0.05 ）. The VEGF pos- itive rate was higher in younger （ 66.7 % versus 41.7 % ）, lymph node-positive （ 51.1 % versus 37.1% ）, and p53-positive （ 51.8 % ver- sus 34.0 % ） patients. However, the differences were insignificant. Moreover, TNBC patients with positive VEGF expression were more prone to relapse and metastasis （ 23.9 % versus 9.7 % ）. The 3-year disease-free relapse （ DFR ） rate was lower in VEGF-positive pa- tients than in VEGF-negative patients （ 76.6 % versus 90.3 %, P = 0.044 ）. Conclusion： VEGF is one of the predictive factors for the DFR rate of TNBC patients, which could be an important research topic for future studies.